Effects of Foot Strengthening on the Incidence of Injuries in Long Distance Runners

Effects of a Foot Strengthening Program on the Incidence of Injuries, Foot Functionality and Health in Long Distance Runners: a Randomized Controlled Trial.

The main objective of this trial is to investigate the effects of a training protocol for the foot and ankle complex on the prevalence of running related injuries on long distance runners.

Using a web software as a follow up tool, subjects can be scanned for injuries and have them confirmed by a physician, determining the injuries prevalence in one year. Through force platform and infrared cameras, the kinematics and kinetics during gait will allow assessment of joint moments, power during propulsion, ankle and knee range of motion. The hypothesis is that a strengthening program for foot and ankle muscles can alter the prevalence of lower limbs injuries on long distance runners, lowering the harmful forces that these segments receive. The participants will be randomly assigned into control group (placebo intervention) or into intervention group, that will receive an 8 weeks strengthening intervention, twice a week with the supervision of a physiotherapist and three times a week being remotely supervised by a software at home, for 30 minutes each session. This will aim for increasing foot and ankle range of movement and muscle strength. Every exercise has its own progression depending on the subjects execution, increasing in intensity and difficulty.

Group will practice 15 seconds isometric lower limb stretching protocol and must continue practicing running as usual.

Group will be trained during 2 months by a physiotherapist for foot and ankle strengthening and must continue to exercise at home with a training software supervision. Must continue practicing running as usual.

Group will be trained during 2 months at the university by a physiotherapist and at home with a training software for foot and ankle strengthening.

Foot and ankle Kinematics during gait (ankle range of motion and maximum ankle flexion angle during gait)

Ankle and Knee joint moments during gait (inverse dynamics of the outcome measure of a force platform during subject's gait)

A six components measure that allows multiple segment evaluation of foot posture on a static measurement.

Planimetric measures of the foot blueprint that categorizes the foot in high arch, normal arch or flat arch.

Inclusion Criteria: practice long distance (more than 5 km) running for at least one year; run at least 20 km a week; Exclusion Criteria: run using minimalist shoes or barefoot; having prior experience in isolated foot and ankle strength training within the last year; have any health condition that affect gait and running; being receiving any physical therapy intervention; having any running related injuries during the last two months.

All files will be available in the database published at http://figshare.com after completion of the study.

Suda EY, Watari R, Matias AB, Taddei UT, Sacco ICN. Predictive Effect of Well-Known Risk Factors and Foot-Core Training in Lower Limb Running-Related Injuries in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial. Am J Sports Med. 2022 Jan;50(1):248-254. doi: 10.1177/03635465211056329. Epub 2021 Nov 17.

Watari R, Suda EY, Santos JPS, Matias AB, Taddei UT, Sacco ICN. Subgroups of Foot-Ankle Movement Patterns Can Influence the Responsiveness to a Foot-Core Exercise Program: A Hierarchical Cluster Analysis. Front Bioeng Biotechnol. 2021 Jun 8;9:645710. doi: 10.3389/fbioe.2021.645710. eCollection 2021.

Taddei UT, Matias AB, Duarte M, Sacco ICN. Foot Core Training to Prevent Running-Related Injuries: A Survival Analysis of a Single-Blind, Randomized Controlled Trial. Am J Sports Med. 2020 Dec;48(14):3610-3619. doi: 10.1177/0363546520969205. Epub 2020 Nov 6.

Matias AB, Taddei UT, Duarte M, Sacco IC. Protocol for evaluating the effects of a therapeutic foot exercise program on injury incidence, foot functionality and biomechanics in long-distance runners: a randomized controlled trial. BMC Musculoskelet Disord. 2016 Apr 14;17:160. doi: 10.1186/s12891-016-1016-9.